Intensive management of risk factors for accelerated atherosclerosis: the role of multiple interventions

Abstract

Patients at high risk of vascular events can reduce their risk by 75% to 80% through a combination of lifestyle changes and medical therapy. These include smoking cessation, a Mediterranean diet, daily exercise, maintaining a fit weight, moderate consumption of alcohol, effective control of blood pressure and diabetes, intensive treatment with lipid-lowering drugs and antiplatelet agents, and perhaps treatment with vitamins to lower homocysteine. Much of this is achieved primarily by the patient; physicians need to become better at assisting their patients in making lifestyle changes. Effective control of treatment-resistant hypertension can be improved by individualizing medical therapy to the underlying cause, based on measurement of plasma renin and aldosterone. Measurement of carotid plaque may be useful by providing feedback on the success of therapy.

Prevalência de estenose carotídea em pacientes com indicação de cirurgia de revascularização miocárdica

“…In Brazil, there has been a single report with a 50-individual sample and the rate was 48% and 32% in patients with CS ≥50 and ≥70%, respectively The screening can also aid the diagnosis and follow-up of cases that have an indication for conservative treatment, because the CS is a risk marker itself that persists regardless of its treatment 31 and an opportunity to observe the vascular health in general 32 . To prevent the CVA, the identification and quantification of the CS are of utmost importance 33 .…”

Sensitive three‐dimensional ultrasound assessment of carotid atherosclerosis by weighted average of local vessel wall and plaque thickness change

“…A combination of lifestyle changes and medical treatments would lead to a 75-80% risk reduction for patients with high stroke risk. 5 With these treatment options available, there is a requirement for the development of sensitive biomarkers to assess the effect of various treatment strategies and monitor the progression/regression of carotid atherosclerosis. The proposed biomarker is more sensitive than existing biomarkers and requires fewer subjects to demonstrate the statistical significance, thereby reducing the cost of clinical studies.…”

“…Carotid atherosclerosis is a major source of emboli, which may block one of the cerebral arteries, causing ischemic stroke. Fortunately, 75–80% of vascular events can be prevented through lifestyle/dietary changes and medical therapies . Effects of these treatment and management strategies on the development of carotid atherosclerosis are required to be validated in clinical trials.…”

“…Fortunately, 75-80% of vascular events can be prevented through lifestyle/dietary changes and medical therapies. 5 Effects of these treatment and management strategies on the development of carotid atherosclerosis are required to be validated in clinical trials. Thus, parallel to the development of new therapies or management strategies, there is an important requirement for the development of treatment-specific measurement tools or biomarkers for longitudinal assessment of disease progression and regression.…”

Antithrombotic Treatment in the Prevention of Ischemic Stroke

“…According to World Health Organization estimates, figures are predicted to increase to 23 million first-ever strokes, 77 million stroke survivors, 61 million disability adjusted life years (DALYs) and 7.8 million deaths in the next 20 years [2]. We foresee that patients at high risk of vascular events could reduce their risk by 75 to 80 % through optimal prevention strategies including a combination of lifestyle changes and medical therapy [4]. Over 70 % of ischemic strokes are first events, which makes primary prevention immensely important.…”